Alpha-1 Advocacy Alliance - Emotional Support

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Panic Attacks

A panic attack is an isolated period of intense fear or discomfort, in which four or more of the following symptoms developed quickly and reached a peak within 10 minutes.

Here are some of the symptoms of a panic attack

Palpitations-pounding heart or accelerated heart beat.

Sweating, Trembling or shaking

Sensations of shortness of breathe or smothering.

Chest pain or discomfort

Fear of losing control or going crazy or dying

Numbness or tingling sensation

Chills or hot flashes

First panic attacks are often completely spontaneous, although some follow excitement, physical exertion, sexual activity, or emotional trauma. There are chemical or hormonal imbalances and other situational events that can cause panic attacks. Certain habits and rituals may precede panic attacks, such as:

The use of caffeine, alcohol, nicotine

Unusual patterns—of sleeping or eating

And specific environmental settings--such as harsh lighting, steamy shower or even weather changes

Panic attacks have rapidly increasing symptoms within a ten-minute period.

In cases of extreme fear, individuals may not know the source of their fear and may feel confused or have trouble concentrating.

The physical signs often include tachycardia (excessive rapid heartbeat), palpitations, dyspnea (difficult or labored breathing) and sweating.

The panic attacks last from 20 to 30 minutes and rarely more than an hour.

During the panic attacks, one's mental status may go over an event or situation repeatedly and they may have difficulty in speaking (stammering), and/or an impaired memory.

Individuals may experience depression (symptoms like profound sadness or irritability, and thoughts of suicide).

Individuals may experience depersonalization (void of personality or individuality)

Biologically, panic attacks may have a genetic inheritability or predisposition and point to physical defects in the autonomic nervous system.
Somatic (body) symptoms:

Concerns about death from cardiac or respiratory problems may be the major focus of the individual's attention during a panic attack.

Many individuals believe that the chest pains or palpitations they are experiencing indicate that they are going to die.

Sometimes there is a brief loss of consciousness associated with an inadequate flow of oxygenated blood to the brain during a panic attack.

Sometimes the age-old treatment of breathing into a paper bag helps with hyperventilation.

Panic Disorders (PD) start usually during late adolescence or early adulthood. Panic attacks are chronic and may occur several times a day or only once a month.

30 to 40 % of individuals with PD are symptom free long term.

50 % of individuals with PD have mild symptoms.

Between 10 to 20 % of individuals with PD continue to have major symptoms.

75 to 95 % of individuals treated with the combination of medication and psychotherapy show significant signs of improvement.

Between 40 to 80 % of the individuals with PD have depression; and about 20 to 40 % of all individuals with PD may have substance abuse problems

By using medication to block the panic attack in combination with cognitive and behavioral therapy, many individuals overcome their fears and return to normal, functional living. The most effective treatments in pharmacology-therapy are Serotonin Specific Reuptake Inhibitors (SSRI's). These drugs increase the serotonin level that governs an individual's sense of well-being.

Psychiatrists prescribe two forms of emotional therapy treatment, cognitive and behavioral. These therapies help the individual learn about their false beliefs that dictate their mind and bodily sensations. Also that when a panic attack occurs, it is time limited and not life threatening.

There are also Family and Group Therapy (directed toward education and support) that may help affected individuals and their families adjust to PD.

By learning applied relaxation techniques and emotion-focused coping skills, you can lower the effect of panic attacks and gain a sense of control. Utilizing techniques such as deep breathing, progressive muscle relaxation and meditation/visualization, individuals learn techniques that may help them through a panic attack. Just because you cannot control a sudden panic attack, does not mean you have to let the panic attack control you.

Deep Breathing Exercise

When you first practice Deep Breathing Exercise, focus on your breathing. This exercise may seem a bit unnatural at first, but it will become more automatic and soothing with practice. Prepare by learning and practicing before a panic attack occurs.

Begin by sitting or standing up straight in good posture while remaining comfortable, close your eyes, place one hand on chest and the other on your abdomen. Try breathing normally initially, focusing on how your chest and abdomen rise and fall. Do you feel a tightness or rigidity? Scan for tension in your throat, chest and abdomen.

Now - Breathe in slowly through your nose.

As you inhale, first fill the lower section of your lungs. Your diaphragm will push your abdomen out to make room for the air and the hand over the abdomen will rise. Continue to inhale and feel the middle part of your lungs expand as your lower ribs and chest move forward slightly to accommodate the air. Finally, feel the upper part of your lungs expand as your chest rises slightly and your shoulders rise and you feel your hand placed beneath your collarbone rise. Draw in your abdomen slightly to support your lungs. Completing this slow deep breath can take only a few seconds as one smooth, continuous inhalation.

Hold your breath for a few seconds.

As you exhale slowly through your mouth, pull your abdomen in slightly and lift it up slowly as the lungs empty. When you have completely exhaled, relax your abdomen and chest. Let the tension out of your shoulders.

At the end of an inhalation phase, raise your shoulders and collarbone slightly so that the very top of your lungs are sure to fill with air.

Practice and become comfortable with the procedure before you have a panic attack. You do not have to do the exercise perfectly to benefit from it.

Relaxation of Muscle Groups

Before you begin, turn the lights down or off. Start by taking a few deep natural breaths. Clear your mind by telling yourself that breathing and relaxation are the only things you need to think about right now. .

First, hand and lower arms – make a fist with the thumb on the outside of the fist, stretch for count of 10, then relax for a count of 10,

Next, upper arms—push elbow into the back of a chair or bed, for a count of 10, then relax for a count of 10,

Next, forehead—arch eyebrows for a count of 10, then relax for a count of 10,

Next, eyes, nose, cheeks—shut eyes tightly, crinkle nose for a count of 10, then relax for a count of 10,

Next, mouth, jaw, neck—Bite down gently on the back teeth make an exaggerated clown frown by drawing the corner of the lips down, for a count of 10, then relax for a count of 10,

Neck and shoulders—draw chin into Adam's apple, for a count of 10, then relax for a count of 10,

Mid body—take a deep slow breath filling the lungs from the bottom to the top, pull shoulder blades back and arch the back, for a count of 10, then relax for a count of 10,

Legs—lift legs up and point toes to floor, for a count of 10, then relax for a count of 10,

Legs—lift legs up and point toes to ceiling, for a count of 10, then relax for a count of 10,

Repeat as many times as comfortable to get the desired effect.

Meditation/Visualization

There are several basic elements common to most approaches to the different types of meditation, which seem best suited to relaxation to manage environmental or situational events.

A “quiet environment” There should be as few distracters as possible such as external sources: telephones or harsh lighting. Closing your eyes help quiet the visual environment. Muscle relaxation techniques, prior to meditating, is a good way to minimize physiological tension.
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A “mental device” Focusing ones attention on a calming word, a phrase, or an image helps quiet the mind by occupying it with an emotionally neutral stimulus.

A “passive attitude” Consciousness is directed away from the logical, cause and effect, goal directed thinking that characterizes us most of the time, an attitude of unconcerned acceptance.

A “comfortable position” This may include sitting on a chair, lying onthe floor or mat.

Relaxation is a restful state without the loss of alertness or decreased physical stimulation. Benefits include lowered oxygen consumption, decreased heart and respiration rates. Older individuals experience improved mental and physical health. A meditative state, from 15 to 20 minutes up to twice a day, is all that is necessary, as longer periods can have negative side effects.

Visualization or imagery is useful in the context it diverts attention from something that is unpleasant (rising anxiety and feelings of impending doom) to an image of something pleasant (dissipating your anxiety like the water from the ocean running across the sand on a beach).

I hope you have found this information helpful.

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